NYC 9/11 Public Portal Document
NYC DEPARTMENT OF ENVIRONMENTAL PROTECTION
•_ Asbestos Control Program
59-17°Junction Boulevard, 81' Floor, Corona. NY 11368-5107 0
ONLY
D `
~O SBESTOS PROJECT NOTIFICATION
UN
FOR OFFKAAL USE ONL
T,•P TT N ' ~, ~ `
F RMS t/tJLL BE •. (ASBESTOS INSPECTION REPORT) 1 $800
(See tae Sd19dUla
i n itti thus form at NYC Department of Buildings, the original form and three (3) copies otigm~l; ~t
are required. Su ittal at the NYGDEP requires one copy of the form with original signatt
form must be submi 9Jj C DEp. not less than one week in advance of the start of abatement activi f
I.FA ~{
10007
Barcla Street
2. A dress _----_._—__Y __________-------- _--______-- Borough Manhattan
--__---- Zip —__-., --_—_---
AKA ______------- ..__—_—__-- 3_ Block 128 4_ Lot 26 —_--
5. Type of Facility-Office Building — _— —__—__--_ 6. Name of Building
II. BUILDING OWNER
7. Name District Council 37 8. Contact Person Ralph Pepe
9. Tel. # (212) 367-1124 __- Fax # (212) 367-1297 —
10. Address 125 Barclay Street -- — _—_________ City New York v State NY Zip 10007 __
III. GENERAL CONTRACTOR
11. Name N/A Tel. # ---__—__--
IV. ASBESTOS ABATEMENT CONTRACTOR
12. Name Safeway Environmental Corp. 13. Contact Person D on Adler
14. Federal• Employer ID. # ' ----------- P __ _: 718)_794-4300_
15. Tel. # (71 _ Fax # (718) 794-1411 _._---
16. Address 1379 Commerce Avenue City Bronx —__ State NY Zip _10461
V. THIRD PARTY AIR MONITOR
17. Name HA Bader Consultants Inc. 18. Contact Person Howard Bader
P 1- 20. Tel. # (212) 475-4122 (212) 477-8941
19. Federal Employer ID. # ;._._._._._._._._._._._._._._._._._._._. _.... _ .__ Fax
21. Address 88 Bleecker Street City New York __ —_-- State NY Zip 10012
22. Sample Analysis Laboratory_EMSL Analytical 23. NYS DOH ELAP # 11506
VI. PROJECT INFORMATION
24. Starting date for this portion of work 11/26101 Projected completion date 1/31/02
Asbestos work schedule El Monday El Tuesday El Wednesday El Thursday El Friday ❑ Saturday ❑ Sunday
Shift from: 7 - 1 am ❑ pm to 5 ❑ am [a pm
If other,
specify
Access to inspect the premises must be provided during the work schedule indicated in this item.
J
25. Total amount of asbestos-containing material to be abated during this work
370 Square Feet, and/or 0 Linear Feet
NYC-WTC 000119417
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